The LASSO Program in Oslo: Harm Reduction Using Buprenorphine-Naloxone (Suboxone®) in a Low Threshold Setting

Area of Science:

• Addiction Medicine
• Pharmacotherapy
• Public Health

Background:

• Retrospective quality control study of the LASSO Program in Oslo.
• Focus on buprenorphine-naloxone (BPNX) in outpatient, low-threshold settings.
• Addresses challenges of opioid withdrawal avoidance in induction.

Purpose of the Study:

• To assess the safety and feasibility of buprenorphine-naloxone (BPNX) in low-threshold addiction treatment.
• Evaluate BPNX as an alternative to methadone in outpatient settings.

Main Methods:

• Daily supervised buprenorphine-naloxone (BPNX) administration.
• Standardized induction with dose titration (4-16 mg daily).
• Evaluation of induction attempts, treatment duration, and lag time.

Main Results:

• 76.4% of patients completed induction on the first attempt; 85.2% with successive attempts.
• No significant association between lag time and treatment duration.
• Median treatment duration of 52 days with an average of 3.9 inductions.
• No severe precipitated withdrawal; only 2 adverse reactions out of 1,293 inductions.

Conclusions:

• Buprenorphine-naloxone (BPNX) is highly effective for marginalized heroin addicts in low-threshold settings.
• High induction completion rates and safety profile demonstrated.
• Individualized approaches to induction readiness and patient motivation are key to success.